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The task of removing brain tumors is complicated by the fact that gliomas have no clear boundaries – they grow into the surrounding brain, and MRI does not detect these zones of infiltration (that is, penetration of tumor cells into healthy tissues). Because of this, according to the scientists' observations, 50–90% of patients experience recurrences.
The technology, which scientists from PIMU (Nizhny Novgorod) reported in the journal Biomedical Optics Express, is based on analysis of the natural luminescence of tissues.
How does the technology work?
Any living tissue under the influence of light emits its own fluorescence – the glow of NAD(P)H and FAD molecules. When the external light source is turned off, this glow does not fade instantly, but gradually. The decay time is a kind of "biochemical fingerprint" of the tissue.
Tumor cells have altered metabolism, so their glow fades differently than that of healthy neurons. Macro-FLIM registers this difference at each point of the sample and builds, including with the help of a neural network, a "metabolic map" of the tissue, showing where there are tumor cells and where there is healthy tissue.
How is it applied in practice?
The surgeon removes the visible part of the tumor, then takes a small tissue sample from the boundary of the surgical cavity – the zone where it's unclear whether it's tumor or already healthy tissue. Instead of sending it for traditional histology, which takes an hour or more, the sample is analyzed using the macro-FLIM method. The result is ready in 2 minutes: whether there are tumor cells in the sample or not. This allows the surgeon to decide – whether to continue removal or stop.
The study by Nizhny Novgorod researchers was conducted on 110 tissue samples from 53 patients. The accuracy of tumor detection was 87%.
The researchers plan to expand the patient sample, improve the accuracy of automatic tumor recognition, and conduct comparison of FLIM images not only with their morphological but also with molecular features.
Other methods for detecting brain tumor boundaries are already being used in the world. The most common method is 5-aminolevulinic acid (5-ALA). The patient drinks the drug 3-4 hours before surgery, tumor cells accumulate it and glow pink-red under blue light. But there is a critical limitation – the method works only for aggressive gliomas, whereas the PIMU methodology is more universal.
Source: Biomedical Optics Express
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